The case against single payer health care
I don't have a philosophical argument against single payer health care, I have a practical one. I don't see it working in other countries and I have not seen Government health programs work in the US.
England - They have National Health Service (NHS) that covers everything. However, there is also a strong private care sector in England where people with sufficient money or health insurance can get care.
Canada - They have a version of national health coverage and for a while even banned the sale of health insurance. Nevertheless, to avoid having to wait for services or to obtain better care, Canadians would travel to the U.S. for health care. Also, someone challenged the law banning health insurance and their Courts overturned that so they now have a growing health insurance market place.
Australia - They have a version of government health coverage where the local governments cover preventive service and the national government provides coverage of inpatient services. Yet everyone who can afford it buys health insurance to cover elective hospital care in order to have access to better care faster.
Regarding all of the countries above, if the Government health coverage is so good why are people who live in those countries and who have the benefit of those programs taking money out of their pockets to buy private insurance? The bottom line in those countries is that there is a health care system for people who can only afford the Government programs and there is a health care system for people who can afford private insurance. How is that different than what we have in the US?
Then there is the United States. We don't have single payer health care but we do have government run health programs. The performance is less than stellar.
Medicaid - This program has a history of providing lousy service to the poor, primarily because of the low reimbursement paid by Medicaid to providers for their services. I can write a lengthy article about the problems I've seen in this program since the early 1980's. It was not until populated States began subcontracting Medicaid to HMOs that poor people were able to gain access to the same providers of care that people with employer sponsored health insurance could access.
Indian Health Services - Another program that has a history of providing lousy service to the population being served. I've met with people who work for consulting firms, software companies, and state governments and the general consensus is these are incredibly poorly run operations. How bad? One person told me the rule of thumb on the Reservation is that if you're going to get sick, do it during the first 6 months of the year because after that they have run out of money to pay for health care.
Veteran's Administration - the stories coming out about services to our veterans through the VA are just tragic. Horrible care, delays in getting appointments, long wait lists to become eligible - veterans put their lives on the line for our country and the way they are served is unspeakably bad. I won't recount what you either already know or can readily look up just by searching the news, since stories come out almost every day.
Medicare - open the phone book in any populated area and look in the yellow pages under lawyers. You'll see attorneys who specialize in helping people get Medicare benefits. If Medicare is so good why is their a cottage industry of lawyers around the Country doing this? Also, if Medicare is so good, why did the Government subcontract to HMOs to provide coverage to senior citizens and why are so many senior citizens signing up for these programs?
Let's recap - in the US, Government health coverage programs have a service record that runs from poor to tragic and they have had to contract with private health plans to provide alternatives. In other countries with single payer health plans, people are so displeased with the programs that anyone who can afford it will buy private insurance so they can seek care when they want it from who they want it.
I invite advocates of single payer coverage to tell me how the US Government is going to create a program that a) addresses whatever shortcomings that causes people in countries with government health programs to seek private insurance and b) not be a failure like so many other Government sponsored health coverage programs in the US to date.
England - They have National Health Service (NHS) that covers everything. However, there is also a strong private care sector in England where people with sufficient money or health insurance can get care.
Canada - They have a version of national health coverage and for a while even banned the sale of health insurance. Nevertheless, to avoid having to wait for services or to obtain better care, Canadians would travel to the U.S. for health care. Also, someone challenged the law banning health insurance and their Courts overturned that so they now have a growing health insurance market place.
Australia - They have a version of government health coverage where the local governments cover preventive service and the national government provides coverage of inpatient services. Yet everyone who can afford it buys health insurance to cover elective hospital care in order to have access to better care faster.
Regarding all of the countries above, if the Government health coverage is so good why are people who live in those countries and who have the benefit of those programs taking money out of their pockets to buy private insurance? The bottom line in those countries is that there is a health care system for people who can only afford the Government programs and there is a health care system for people who can afford private insurance. How is that different than what we have in the US?
Then there is the United States. We don't have single payer health care but we do have government run health programs. The performance is less than stellar.
Medicaid - This program has a history of providing lousy service to the poor, primarily because of the low reimbursement paid by Medicaid to providers for their services. I can write a lengthy article about the problems I've seen in this program since the early 1980's. It was not until populated States began subcontracting Medicaid to HMOs that poor people were able to gain access to the same providers of care that people with employer sponsored health insurance could access.
Indian Health Services - Another program that has a history of providing lousy service to the population being served. I've met with people who work for consulting firms, software companies, and state governments and the general consensus is these are incredibly poorly run operations. How bad? One person told me the rule of thumb on the Reservation is that if you're going to get sick, do it during the first 6 months of the year because after that they have run out of money to pay for health care.
Veteran's Administration - the stories coming out about services to our veterans through the VA are just tragic. Horrible care, delays in getting appointments, long wait lists to become eligible - veterans put their lives on the line for our country and the way they are served is unspeakably bad. I won't recount what you either already know or can readily look up just by searching the news, since stories come out almost every day.
Medicare - open the phone book in any populated area and look in the yellow pages under lawyers. You'll see attorneys who specialize in helping people get Medicare benefits. If Medicare is so good why is their a cottage industry of lawyers around the Country doing this? Also, if Medicare is so good, why did the Government subcontract to HMOs to provide coverage to senior citizens and why are so many senior citizens signing up for these programs?
Let's recap - in the US, Government health coverage programs have a service record that runs from poor to tragic and they have had to contract with private health plans to provide alternatives. In other countries with single payer health plans, people are so displeased with the programs that anyone who can afford it will buy private insurance so they can seek care when they want it from who they want it.
I invite advocates of single payer coverage to tell me how the US Government is going to create a program that a) addresses whatever shortcomings that causes people in countries with government health programs to seek private insurance and b) not be a failure like so many other Government sponsored health coverage programs in the US to date.
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